Tapio Joona, Grönlund Tommi, Kaikkonen Kari, Junttila M Juhani, Tulppo Mikko P, Koivunen Peppi
Biocenter Oulu and Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, Oulu, Finland.
Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland.
Ann Med. 2024 Dec;56(1):2425061. doi: 10.1080/07853890.2024.2425061. Epub 2024 Dec 3.
Within normal variation, higher haemoglobin (Hb) levels are associated with unhealthier body composition, adverse metabolism and cardiovascular disease (CVD)-related mortality. Global longitudinal strain (GLS) is a direct, well validated and reproducible echocardiographic measure for the evaluation of cardiac contractile function, providing additional prognostic value for prediction of a variety of cardiac events. This study investigated the relation between Hb levels and cardiac function measures, including GLS, in a Finnish midlife population.
Echocardiography was carried out in a subpopulation of the Northern Finland Birth Cohort 1966 at age of 46 ( = 1155). GLS was available for = 796. Subjects with diabetes, severe cardiac diseases, echocardiographic abnormalities, heart rate ≥85 bpm during echocardiography or Hb level outside the Finnish reference intervals (117-155 g/L for females and 134-167 g/L for males) were excluded from the analysis. The study population included 635 subjects (46% males). The data were analysed in Hb tertiles and in multivariable linear regression models.
The highest Hb tertile had adverse anthropometric and metabolic parameters compared to other Hb tertiles. Of the studied echocardiographic parameters, the highest Hb tertile had the highest left ventricular mass (LVM, < .01), LVM index (LVMi, < .05), LV end-diastolic volume (LVEDV, < .05), posterior wall thickness (PWT, < .001), relative wall thickness (RWT, < .05) and the lowest absolute GLS ( < .001) but no difference in LV ejection fraction (LVEF) was observed between the Hb tertiles. In linear models, when adjusted for covariates, Hb levels were associated positively and independently with GLS ( = 0.153 [0.071; 0.235]) and LVM ( = 0.272 [0.193; 0.350]).
Higher Hb levels are associated with an adverse metabolic and inflammatory profile and more adverse cardiac function measures, including GLS, in both sexes in midlife.
在正常变异范围内，较高的血红蛋白（Hb）水平与不健康的身体成分、不良代谢及心血管疾病（CVD）相关死亡率有关。整体纵向应变（GLS）是一种直接、经过充分验证且可重复的超声心动图测量方法，用于评估心脏收缩功能，为预测各种心脏事件提供额外的预后价值。本研究调查了芬兰中年人群中Hb水平与包括GLS在内的心脏功能指标之间的关系。
对1966年芬兰北部出生队列中46岁的亚组人群（n = 1155）进行了超声心动图检查。有796人可获得GLS数据。分析时排除了患有糖尿病、严重心脏病、超声心动图异常、超声心动图检查期间心率≥85次/分钟或Hb水平超出芬兰参考区间（女性为117 - 155 g/L，男性为134 - 167 g/L）的受试者。研究人群包括635名受试者（46%为男性）。数据按Hb三分位数及多变量线性回归模型进行分析。
与其他Hb三分位数相比，最高Hb三分位数组具有不良的人体测量学和代谢参数。在所研究的超声心动图参数中，最高Hb三分位数组的左心室质量（LVM，P <.01）、左心室质量指数（LVMi，P <.05）、左心室舒张末期容积（LVEDV，P <.05）、后壁厚度（PWT，P <.001）、相对壁厚度（RWT，P <.05）最高，而绝对GLS最低（P <.001），但各Hb三分位数组之间左心室射血分数（LVEF）无差异。在多变量线性模型中，校正协变量后，Hb水平与GLS（β = 0.153 [0.071; 0.235]）和LVM（β = 0.272 [0.193; 0.350]）呈正相关且独立相关。
中年男女中，较高的Hb水平与不良的代谢和炎症特征以及包括GLS在内的更不良的心脏功能指标相关。
